This invention relates to an improved walking aid and, in particular, to a walking aid adapted to support a patient during physical therapy.
In the fields of rehabilitation medicine and physical therapy, it is well known that a variety of motor disturbances can result from traumatic brain injury (TBI). Among them are paralysis or paresis which can involve isolated muscle groups, limb combinations, or the entire body. For example, disorders of balance and coordination can result from damage to the cerebellum or its connections. Even those patients with good muscle strength may therefore be unable to ambulate owing to profound ataxia, which is the dysfunctional gait that results from the brain""s failure to regulate posture as well as the strength and direction of limb movements. Ataxia is, unfortunately, very difficult to treat.
It is also well known that patients who have suffered a debilitating stroke often have severely compromised ambulation. When a patient becomes hemiplegic following a stroke, the central motor and the sensory tracts are disrupted. Most patients with hemiplegia exhibit very primitive pattern motion whenever there is serious impairment of selected motor control. Such primitive pattern motion makes difficult forward progression as well as body transfer from one position to another. The transfer from a standing position to a walking gait is especially difficult because, added to the demands of balance, is the task of lifting the body""s weight with each step. Until a patient can attain a standing position without the aid of another, that patient is not an independent walker.
For victims of stroke, most patients eventually ambulate with assistive devices, and the physical therapist will need to use a variety of progressive activities and equipment aimed toward independent ambulation. For example, parallel bars have been used for sitting, standing, walking, and balance activities, which are prerequisites for functional transfers and ambulation. However, even well-meaning attendants have been known to report a patient to be ambulating when actually the patient is being essentially dragged by two attendants, unable to advance his or her extremities independently. Hemiplegic patients lacking independent ambulation may be provided with a hemiplegic wheelchair. The goal however is to facilitate the transfer from such a chair to a walking position so that the patient can progress towards independent ambulation. Presently, waist-high walkers, quad-canes or straight canes are conventionally employed when the patient becomes more advanced.
Walking aids or xe2x80x9cwalkersxe2x80x9d have been used for many years by the elderly for support while walking and for protection against falling. During the use of such conventional walkers, which requires full upper body mobility, strength, and coordination, a person moves forward by picking up the walker frame and moving it forward a short distance so that a step or two can be taken until the process is repeated. Such conventional walkers are not, however, well adapted for therapeutic use with patients who have suffered severe trauma such as those patients who have suffered tragic TBI or a debilitating stroke. Such patients must undergo rigorous physical therapy in order to relearn various aspects of physical development, including standing and walking patterns, in order to provide a transition from a wheelchair to independent ambulation. Therapeutic sessions are often used in order to xe2x80x9cpatternxe2x80x9d the walking function while the patient is maintained in an upright position. The therapeutic session usually concentrates on the movement of the patient""s lower body and moves the patient""s legs while immobilizing and securing the upper body of the patient.
Therapeutic rehabilitation of patients who have suffered TBI or stroke beneficially begins once the patient is able to stand with assistance so that walking and standing patterns can be reestablished. Therapeutic rehabilitation of TBI patients, for example, conventionally requires the assistance of two or three rehabilitation specialists to facilitate a one-half to one hour session. Conventional walking aids do not adequately support the patient in the upright position with adequate upper-body support so that a therapist can attend to guidance of the patient""s lower body.
Moreover, conventional rehabilitation of larger adult patients is limited due to the risk of injury to hospital staff members. It has been discovered that rehabilitation patients undergoing strenuous therapeutic sessions can quickly or even suddenly become physically exhausted and unable to support themselves. This is particularly true with patients suffering ataxia as the result of TBI. Such exhaustion also occurs in connection with patients who have suffered debilitating strokes. When such exhaustion occurs, the patient is likely to collapse partially or completely as he or she becomes unable to provide any self-support. For this reason, it is often necessary to make a sudden transfer of the patient from the standing position to a wheelchair. Transfers of this kind have been very difficult in the past because therapeutic aids often interfere with the transfer if they come between the patient and the wheelchair. Also, conventional aids fail to adequately support the patient while waiting for such a transfer.
Over the years, various attempts have been made to provide improved walking aid devices. U.S. Pat. No. 5,224,717 to Lowen describes a walking aid device which is said to allow a user to retain a full upright position while providing continuous support of a portion of the user""s body weight. The Lowen device includes a rib rest means disposed in a plane slightly below the plane of armrests.
U.S. Pat. No. 5,347,666 to Kippes describes a transfer aid device for assisting people to rise from a seated position into a standing position. The Kippes device includes a grasping portion having two shafts for the patient to clutch and pull on when rising into a standing position.
U.S. Pat. No. 5,605,169 to Light discloses a collapsible walker with a retractable seat. When the user wishes to rest, the seat can be moved from its stored or horizontally retracted position to a vertical position by pushing the seat downward.
U.S. Pat. No. 5,271,422 to Sorrell et al. discloses a front entry safety walker having a porous seat to accommodate incontinent patients. The Sorrell walker also includes a rear wheel mechanism. A top of the rear frame is bent away from the patient.
U.S. Pat. No. 4,314,576 to McGee discloses an apparatus composed of a number of tubular elements formed into a frame. A person in a wheelchair may approach the frame and pull himself or herself into position within the frame to stand, to walk, and to exercise without the assistance of other persons.
Despite these numerous attempts to provide an improved walking aid system, none of the conventional walkers are suitably adapted for therapeutic support of persons who have suffered TBI or stroke, wherein the patient is supported during a therapeutic session in such a way that ambulation can be patterned by a therapist while the patient""s upper body is supported.
This invention provides a therapeutic walking aid having spaced apart side portions that partially defme an interior space which can be occupied by a patient to support the patient in an erect position. The walking aid is specifically adapted for use by patients, such as those that have suffered ataxia, TBI or a debilitating stroke, during rehabilitation and relearning of the standing and ambulation functions.
The walking aid according to this invention includes side portions spaced from one another to defme an open interior space sized to accommodate the patient. Each side portion includes an arm support. The walking aid also includes a back portion extending between the side portions. The back portion of the walking aid includes a back support extending upwardly to an elevation above the arm supports.
In one preferred embodiment of the invention, the back portion of the walking aid defines a back opening that is sized and shaped to permit wheelchair access into the interior space of the walking aid. In this embodiment, a wheelchair can be at least partially introduced into the interior space of the walking aid through the back opening to receive a patient for removal from the interior space. Wheelchair accessibility has been discovered to facilitate the transfer of a patient from the walking aid into the wheelchair at the end of a therapeutic session in a safe and efficient manner.
According to another aspect of the invention, wheels are provided for mobility of the walking aid with respect to the floor. When viewed from above according to one aspect of the invention, the walking aid has a substantially U-shaped configuration with an open front portion to facilitate ingress and egress of a patient into and out from the interior space of the walking aid. Such a preferred configuration has been discovered to securely brace the upper body of the patient so that ambulatory functions can be patterned by a physician or therapist without requiring the physician or therapist to support the patient""s upper body.